Long Covid epidemiology (prevalence, incidence, recovery rates)

Yesterday I was sent a link that may help people access the Times article behind the pay wall. Also if it works you get to see the comments, some reflecting the harm this article is contributing to for Long Covid sufferers as well as on people with ME by advocates of the psychosomatic, by enabling more nastiness.

Share token link

https://www.thetimes.co.uk/article/...0?shareToken=1586575306dd66ac70fbca52a4c4b411

Also you register with the Times for two free articles a week, which also enables you to comment on those free articles too.

On the depressingly vitriolic Dr Devine:

"Devine thinks that the root of the UK’s long Covid abundance is in the fierce debate over myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS), which has left a deep imprint in the British medical and patient community. “The reason this is so prevalent in the UK is because of the chronic fatigue lobby,” he says. “They have shaped the discourse on long Covid. You guys are the origin.”

 

“People don’t fully appreciate the ability of the psyche to convince itself that it’s sick"

Now there is a quote that could benefit from some analysis. This is clearly someone who was not too good for psychiatry.

 

Abstract

Background
Emerging evidence suggests many people have persistent symptoms after acute COVID-19 illness. Our objective was to estimate the prevalence and correlates of post-acute sequelae of SARS-CoV-2 infection (PASC).

Methods
We employed a population-based probability survey of adults with COVID-19 in Michigan. Living non-institutionalized adults aged 18+ in the Michigan Disease Surveillance System with COVID-19 onset through mid-April 2020 were eligible for selection (n=28,000). Among 2,000 selected, 629 completed the survey between June - December 2020. We estimated PASC prevalence, defined as persistent symptoms 30+ (30-day COVID-19) or 60+ days (60-day COVID-19) post COVID-19 onset, overall and by sociodemographic and clinical factors, including self-reported symptom severity and hospitalization status. We used modified Poisson regression to produce adjusted prevalence ratios (aPR) for potential risk factors.

Results
The analytic sample (n=593) was predominantly female (56.1%), aged 45 and older (68.2%), and Non-Hispanic White (46.3%) or Black (34.8%). 30- and 60-day COVID-19 were highly prevalent (52.5% and 35.0%), even among non-hospitalized respondents (43.7% and 26.9%) and respondents reporting mild symptoms (29.2% and 24.5%). Respondents reporting very severe (vs. mild) symptoms had 2.25 times higher prevalence of 30-day COVID-19 ([aPR] 2.25, 95% CI 1.46-3.46) and 1.71 times higher prevalence of 60-day COVID-19 (aPR 1.71, 95% 1.02-2.88). Hospitalized (vs. non-hospitalized) respondents had about 40% higher prevalence of both 30-day (aPR 1.37, 95% CI 1.12-1.69) and 60-day COVID-19 (aPR 1.40, 95% CI 1.02-1.93).

Conclusions
PASC is highly prevalent among cases reporting severe initial symptoms, and, to a lesser extent, cases reporting mild and moderate symptoms.

Open access, https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciab408/6276644

 

Do medical texts teach "post-acute"? Is that a thing?

Or does it go a)Acute, b)Chronic, with recovery/convalescense/or death coming after either a or b?

Acute = time limit. Chronic = indefinite.

 

Probably Jungian. Who said "duality" was dead?

Sorry for quoting my own post.

 

In my opinion long covid is for the most part post viral fatigue not ME/CFS. I am basing this on the many recovery stories I've read on the reddit longhauler forums. Maybe I'll be proven wrong, but I think after 2 years (from infection) the vast majority of long haulers would have recovered, the percentage of people to develop true ME/CFS would be quite small, let's not forget ME/CFS is a rare disease after all.

 

Many Post-Covid Patients Are Experiencing New Medical Problems, Study Finds

https://www.nytimes.com/2021/06/15/health/covid-19-patients.html?smid=url-share

An analysis of health insurance records of almost two million coronavirus patients found new issues in nearly a quarter — including those whose Covid infection was mild or asymptomatic.

...

The study, tracking the health insurance records of nearly two million people in the United States who contracted the coronavirus last year, found that one month or more after their infection, almost one-quarter — 23 percent — of them sought medical treatment for new conditions.

Those affected were all ages, including children. Their most common new health problems were pain, including in nerves and muscles; breathing difficulties; high cholesterol; malaise and fatigue; and high blood pressure. Other issues included intestinal symptoms; migraines; skin problems; heart abnormalities; sleep disorders; and mental health conditions like anxiety and depression.

Post-Covid health problems were common even among people who had not gotten sick from the virus at all, the study found. While nearly half of patients who were hospitalized for Covid-19 experienced subsequent medical issues, so did 27 percent of people who had mild or moderate symptoms and 19 percent of people who said they were asymptomatic.​

Bad phrasing that will no doubt be used by ideologues pushing the test=real no-test=psychosomatic. Should have said patients who did not experience significant acute symptoms.

 

The Times has published Dr Shepherd’s response to the problematic article ‘Why is Britain the Long Covid Capital of the World. His most telling point is the figures indicate that estimated levels of Long Covid are no higher in the UK than elsewhere, and indeed are lower than reported for some countries:

see https://meassociation.org.uk/2021/0...eTQ-jbr99T9foFaNCdd3oqbZmufhby5cXCI7xv-P1W7dE

Why does the the anti ME/CFS lobby repeatedly base their arguments on misinformation?

 

See also: recursion.

 

An Australian study:

No mention of post-viral illnesses or ME/CFS, but that's hardly surprising given Australian doctors' hostility and ignorance towards ME.

 

Full paper is out: https://pubmed.ncbi.nlm.nih.gov/34162913/.

 

One notable thing I keep seeing is how all over-the-place research findings have been in terms of incidence rates. So far I don't really see much tightening of uncertainty, rates basically range between none and half.

Some papers about LC in children seem to go from a low of 1%, and barely at that, all the way to 1/3. And all they do is ask people for ne onset symptoms. That simple task produces wildly different results almost every time and not improving with time.

This has a feel of physics and chemistry before the invention of reliable thermometers. I have no idea how that's supposed to work, when common tools and instruments give completely different results at almost every attempt. This continues to be a real obstacle to making any progress.

https://twitter.com/user/status/1417093740364189700

 

Press release:

Certainly an ambitiously large study: they're sending questionnaires to 300,000 covid cases, i.e. pretty everybody in Denmark who has tested positive to date, and 300,000 controls. Response rate to be seen of course.

https://translate.google.com/transl...fysiske-og-psykiske-senfoelger-efter-covid-19
Original Danish: https://www.ssi.dk/aktuelt/nyheder/2021/fysiske-og-psykiske-senfoelger-efter-covid-19

More info on the planned study: https://covid19.ssi.dk/overvagningsdata/undersoegelser/efter-covid
https://translate.google.com/transl...k/overvagningsdata/undersoegelser/efter-covid

Which states there'll be questionnaires asking about the following:

Sooo, another study to ignore PEM?

 

Moved post

Continuing on that. It's definitely a growing theme lately, in part because of a recent Lancet study that is sure to be an underestimate and still causes serious concern.

The video I mentioned yesterday:

https://twitter.com/user/status/1422574734399754243


The Lancet study mentioned, which some people find encouraging:

https://twitter.com/user/status/1422694271845502980


And others find very much not encouraging:

Especially as this repeats previous mistakes of relying on the ZOE app, which despite strong criticism has not adapted to the obvious concerns raised:
https://twitter.com/user/status/1422800835562647554

 

https://www.eurekalert.org/news-releases/924259

NEWS RELEASE 3-AUG-2021
The Lancet Child & Adolescent Health: Long-lasting symptoms from COVID-19 are rare in children, large UK study confirms

Children who develop symptoms of COVID-19 typically get better after six days and the number who experience symptoms beyond four weeks is low (4.4%, 77/1,734)

Peer-Reviewed Publication
THE LANCET

• UK study offers first detailed description of COVID-19 illness in symptomatic children aged five to 17 years. Analysis reported today focuses on data from 1,734 children who tested positive for COVID-19 close to the onset of symptoms and whose symptoms were reported regularly until they were healthy again.
• Children with COVID-19 typically recovered within a week and had few symptoms (average illness lasted six days, average of three symptoms experienced), and almost all symptomatic children recovered by eight weeks (98.2%), providing reassurance about long-term outcomes from COVID-19.
• Nevertheless, some children (4.4%) experienced symptoms beyond four weeks and had an average of two persistent symptoms (typically fatigue, headache or loss of sense of smell). Long illness duration after SARS-CoV-2 infection appears less common in children than in adults.
• Symptoms were reported by a parent or carer through the ZOE COVID Study app and could not be cross-checked against health records.
• Authors highlight that all children with persistent symptoms need timely multidisciplinary care linked with education to support their recovery.

Children who develop symptoms of COVID-19 typically get better after six days and the number who experience symptoms beyond four weeks is low (4.4%, 77/1,734), a large UK study published today in The Lancet Child & Adolescent Health journal has confirmed.

The study, based on data reported through a smartphone app by parents and carers, provides the first detailed description of COVID-19 illness in symptomatic school-aged children and provides reassurance that long-term symptoms are rare.

Professor Emma Duncan, lead and senior author of the study, from King’s College London, UK, said: “It is reassuring that the number of children experiencing long-lasting symptoms of COVID-19 symptoms is low. Nevertheless, a small number of children do experience long illness with COVID-19, and our study validates the experiences of these children and their families.” [1]

Some adults experience a prolonged illness after COVID-19 (sometimes described as “long-COVID”) where symptoms persist for four weeks or longer, but it is not known whether children can develop a similar condition or how common this is. Many children infected with the SARS-CoV-2 virus do not develop symptoms, but those who do tend to have a mild illness.

In the new study, the researchers used data collected through the ZOE COVID Study smartphone app, which includes data from more than 250,000 UK children aged five to 17 years. Symptoms were reported through the app by their parents or carers (rather than assessed directly in children) and the team did not collect data regarding school attendance.

The team focused on reports collected between 1 September 2020 and 22 February 2021. Some 1,734 children developed symptoms of COVID-19 and received a positive PCR test result close to the onset of symptoms, with their symptoms reported regularly until they were healthy again. This meant the researchers could accurately attribute these children’s symptoms to COVID-19 and could assess illness duration robustly. Overall, these children were ill for an average of six days and experienced an average of three symptoms in the first week of illness, confirming that COVID-19 tends to manifest as a mild illness in children and that they usually recover quickly.

Most children recovered within four weeks, with a minority experiencing symptoms after a month (4.4%, 77/1,734). Typically, they had only two symptoms remaining after four weeks. The commonest symptom experienced by children with long illness duration was fatigue. 84% (65/77) of children were reported with fatigue at some point in their illness, and this was the most persistent symptom. Headache and loss of sense of smell were also common, (each symptom experienced by 77.9% (60/79) of children at some stage over the course of their illness). However, headache was more common early in illness whilst loss of sense of smell tended to occur later and to persist longer.

Of the 1,379 children who developed symptoms at least two months before the end of the study period (on or before 29 December 2020), fewer than 2% experienced symptoms for longer than eight weeks (1.8%, 25/1,379).

Older children were typically ill for longer than primary school aged children (average illness duration 7 days in children aged 12 to 17 years vs 5 days in children aged 5 to 11 years). Older children were also more likely to have symptoms after four weeks than younger children (5.1% [59/1,146] children aged 12 to 17 years vs 3.1% [18/588] aged 5 to 11 years), but there was no difference in the numbers of children who still had symptoms after eight weeks (2% [19/934] aged 12 to 17 years vs 1.3% [6/445] aged 5 to 11 years).

Dr Erika Molteni, first author of the study, from King’s College London, said: “We found that nearly a quarter of symptomatic children testing positive for SARS-CoV-2 during the UK’s second wave did not report core symptoms, suggesting the UK testing policy needs reconsideration.” [1]

Importantly, the researchers also assessed the children who tested negative for COVID-19 who may have had other childhood illnesses, such as colds and flu. To do this, they randomly selected a group of age-matched and gender-matched children with symptoms reported through the app who were tested at the same time as the positive children.

Children with COVID-19 were ill for longer compared to children with other illnesses who tested negative for COVID-19 (an average of 6 days’ illness with COVID-19 vs 3 days with other illnesses) and were more likely to be ill for more than four weeks (4.4% [77/1,734] with COVID-19 vs 0.9% [15/1,734] for children with other illnesses). However, at four weeks, the small number of children with other illnesses tended to have more symptoms than those who were ill with COVID-19 (average 5 symptoms in COVID-negative group vs 2 symptoms in COVID-positive group).

Dr Michael Absoud, a senior author of the study and Consultant & Senior Lecturer at King's College London, said: “Our data highlight that other illnesses, such as colds and flu, can also have prolonged symptoms in children and it is important to consider this when planning for paediatric health services during the pandemic and beyond. This will be particularly important given that the prevalence of these illnesses is likely to increase as physical distancing measures implemented to prevent the spread of COVID-19 are relaxed. All children who have persistent symptoms – from any illness – need timely multidisciplinary support linked with education, to enable them to find their individual pathway to recovery.” [1]

The authors note some limitations to their findings. They could not cross-check the symptoms reported by parents and carers with health records (noting that most children were managed in the community), and there may be inconsistencies in the way people interpret symptoms on behalf of their children. Crucially, only children who had an adult who was participating in the COVID Symptom Study were able to participate, which may bias participation towards certain demographic groups.

They also note that their findings on the number of children experiencing prolonged symptoms are lower than the most recent figures from the UK Government’s Office of National Statistics (ONS) [2]. They say this discrepancy may arise because of differences in way the two studies define the end of COVID-19 illness. The current study also allowed for children to have relapsing and remitting symptoms (allowing for periods of a up to a week of being completely healthy). When the ONS used similar cut-offs, the differences between the figures reported here and the ONS data were quite similar. Additionally, ONS estimates are based on data collected monthly, which relies on individuals remembering details of when symptoms were experienced, whereas the COVID Symptom Study collects data in real time.

Professor Emma Duncan added: “We hope our results will be useful and timely for doctors, parents, and schools caring for these children - and of course the affected children themselves.” [1]

NOTES TO EDITORS

The study was carried out by researchers from King’s College London, University College London, Newcastle University, London School of Hygiene & Tropical Medicine, St Thomas’ Hospital, King’s Health Partners, and Zoe Limited. It was funded by Zoe Limited, UK Government Department of Health and Social Care, Wellcome Trust, UK Engineering and Physical Sciences Research Council, UK Research and Innovation, UK National Institute for Health Research, UK Medical Research Council, British Heart Foundation and Alzheimer’s Society.

[1] Quote direct from author and cannot be found in the text of the Article.

[2] The Office of National Statistics: “Prevalence of ongoing symptoms following coronavirus (COVID-19) infection in the UK: 1 April 2021” [Accessed 19 July 2021]
https://www.ons.gov.uk/peoplepopula...coronaviruscovid19infectionintheuk/1april2021

The labels have been added to this press release as part of a project run by the Academy of Medical Sciences seeking to improve the communication of evidence. For more information, please see: http://www.sciencemediacentre.org/w...S-press-release-labelling-system-GUIDANCE.pdf if you have any questions or feedback, please contact The Lancet press office pressoffice@lancet.com

For interviews with the Article authors, Professors Emma Duncan and Michael Absoud, please contact Rebecca Lewis, Senior News and Campaigns Officer, Kings College London E) Rebecca.s.lewis@kcl.ac.uk T) +44 7961 046 72

NOTE: THE ABOVE LINK IS FOR JOURNALISTS ONLY; IF YOU WISH TO PROVIDE A LINK FOR YOUR READERS, PLEASE USE THE FOLLOWING, WHICH WILL GO LIVE AT THE TIME THE EMBARGO LIFTS: www.thelancet.com/journals/lanchi/article/PIISS2352-4642(21)00198-X/fulltext

 

I don't understand this. If they included children who had symptoms again after a week but the ONS did not include them again this study should have had more children as long term than the ONS.

While the figures may be reassuring, 4% of a few is not many but if numbers go up it could become a very large number of sick children very quickly.

 

This is an impressive display of propaganda. The reality of LC in kids was essentially dismissed until recently. Now that they find about 1/7, not necessarily with severe symptoms but still a high %, it is framed as good news since the % is less than an imaginary worse number that is an invalid target, since the mantra was a clear assertion that kids are essentially immune, in large part because it was assumed to be related to severity of initial illness, assumptions framing other assumptions.

That this can be done to public health matters is seriously alarming, this is blatant influence of politics distorting the news, pushing a message that is deliberately misleading. The 1/7 is worthy of discussion, but it's the moving of the goalposts that is problematic, how quickly it can shift from "this simply does not happen" to "well, it's only 1/7 so much better than a worse scenario I would have dismissed as delusional". This is as close to Orwellian as it gets without going all-in. How quickly systems fall in line to politics, even when it conflicts with basic requirements of their job. At some point people will simply stop listening to experts.

https://twitter.com/user/status/1433318405164126208

 

The first tweet is about the Clock study but is more about general findings of LC in kids.

https://twitter.com/user/status/1433195956573462528

https://twitter.com/user/status/1433173915988332545